You are here:

Juvenile Idiopathic Arthritis: Deciding About Total Joint Replacement

Topic Overview

If your child has severe joint damage from
juvenile idiopathic arthritis (JIA), your child's
doctors may recommend a total joint replacement. As you and the doctors work
through this decision together, consider the following:

Your child's age. Consider how old your child is. His
or her bones may still have a lot of growing to do. The decision to have
surgery depends on the size and quality of your child's bones, the size of the
joint replacement parts, the health of the tissues around the joint, and how
likely it is that your child will be able to follow a rehabilitation
(rehab) program.

Amount of growth remaining. Young children who still
have a lot of bone growth remaining may lose some of their growth potential
in height and size if total joint replacement affects nearby growth areas in
the bones.

Size of the bones. Older children have larger bones,
which are easier to fit with total joint replacement parts. Even when total
joint replacement is delayed, many children need custom-fit knee replacement
parts.

Other joint involvement. It is easier to predict the
success of total joint replacement if only one joint, such as the knee joint,
is involved and all other joints in that limb are normal. This is often not the
case in children who need total joint replacement. Other joint abnormalities
may make the surgical procedure difficult or may complicate the recovery
process. For example, a child with an affected knee and hip in the same leg may
have a difficult rehab from total hip replacement if the knee is
painful and stiff.

Ability to use walking aids. If a child's upper
extremities (such as the elbow and shoulder) are affected by arthritis, it may
be hard for him or her to use crutches or walkers during the rehab process
following a total hip replacement.

How long will the joint replacement last? Depending
on how old a child is when diagnosed with JIA, he or she can expect to live for
another 50 to 80 years. Many joint replacements must be redone after 10 to 30
years of use, because the parts loosen. Most children with JIA do not put the
same amount of stress on a total joint replacement as active or athletic adults
who have had replacements for osteoarthritis, but loosening still occurs
eventually. A very young child may need another joint replacement by age 20 and
might need to replace the same joint 3 or 4 times over a lifetime.

Anesthesia. Children with JIA require neck X-rays
before they have any procedure that uses general anesthesia. General anesthesia
causes the muscles of the neck to relax. This can increase the risk of spinal
cord injury in children whose neck joints are affected by JIA. It is
recommended that the child wear a soft neck collar to the operating room to
remind the surgical team of the potential for cervical (neck) spine problems.

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use.
How this information was developed to help you make better health decisions.